Provider Demographics
NPI:1659693802
Name:BAUMANN, ANDREW KEITH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:KEITH
Last Name:BAUMANN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5085 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSLEY
Mailing Address - State:MI
Mailing Address - Zip Code:49649-9461
Mailing Address - Country:US
Mailing Address - Phone:989-506-6323
Mailing Address - Fax:
Practice Address - Street 1:1712 S GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-4338
Practice Address - Country:US
Practice Address - Phone:231-941-8432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist